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10/20/2015 TLiE 16:31 FA1 425 379 7045 WA Natural Gas � 001/002 <br />• . <br />PERMIT APpLtCATlON <br />BUILDING/MECHANICAL/PLUMBINGfSiGN/SPRINKLER/DEM�L[TION <br />CITY OF EVERETT PERMIT SERVICES <br />� 3200 Cedar Sf., Everett, WA 9820'E 425-257-881C3 FAX 425-257-8857 www.everettwa.org <br />TSS: <br />_� <br />PERTY TAX t� PERMtT # <br />�3"�� �iG��2��.�D� h'��I I� I f �' <br />LEGAL for new consfruction: Short P1aUsubdivision Lot No. (attach copy of long legat description) <br />L..�.�.,.-., ..�., . �. ��,� i , , `� v..c <br />S .�D/9- � 7� �/� � <br />CANT: _ Owner �wner's Agent _ <br />CONTRACTOR <br />PhonelE-mail <br />Contractor _ Contractors Agent <br />BUILDING PERMIT APPLICATION <br />� <br />T8f12�i (m❑st provide a letter o� consent from Ibe o�mer to do work in the <br />� State Lic. # T� /,3�QC1ty Bus. Lic. #G <br />�g� Phone/Emaii ds-� y r <br />CONTACF FOR PEf2i�AIT <br />�'t� 7�5�'-�i�l, Z �-�- 3 �f 7 /�i/ � <br />Phone/E-mail u��fitt,��G _,9. � <br />CONTRACT PRiCE OF WOFtit �b J��,� G�� � <br />Existing Use of Buiiding HEAT <br />Proposed Use of 8uilding Gas Ei <br />Building type: _ Singfe Family _ Duplex _Townhouse ` Multi-Family � Commercial <br />Type of project: New Addition Remodel Repair T f Si�n Sprinkler Demoliti< <br />DESCRlPTION OF WORK (additio al space provided on the back): <br />��,ri�1� D� � �� -�� /�,�� �� �ur�t�r'_ _P . <br />U <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn �Aiteration _Repair <br />Show Number # of fixtures <br />A/C - air handiin units <br />Forced air s stems <br />Gas i in <br />Water heater <br />Gas fireplace <br />hood <br />tfan <br />llnit heater <br />I Woodstove <br />� buctinq <br />j Other <br />SPRINKLER ( SUPPRESSION SYSTEM <br />Number of 1-#eads <br />of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New �Addn _Alterafion _Repair <br />Show Number (#J of �xtures <br />i Toilef <br />Kitchen sink & dis <br />Dishwasher <br />Clothes washer <br />Wafer heafer <br />Sink (service/bar/ <br />Backflow preventE <br />Urinal <br />Drinkinq Fountain <br />Floor drain <br />Roof drains <br />Medical Gas <br />Oiher: <br />Other: <br />I hereby certify that I have read and examined this application and know the same to be We and correct. Ail provisions of laws and ordinances goveming fhis type of work will be comp! <br />with whether specified herein or not. The granting of a permit does not presume fo give authority to viotate or cancel the provision of any other siate or local law regulating construction <br />That I am authonzed by the owner of this property to perform �he work for wMch application is made and I comply with the State Contractors Law 1827 RCW and 236.ZOOA WAC. <br />